Advances in metformin for the treatment of non-alcoholic fatty liver disease in children

ABSTRACT

Introduction

The increased economic and social burdens for NAFLD worldwide make treating such a disease a significant public health issue. Metformin, a kind of insulin sensitizer generally used to treat type 2 diabetes, has been recently found to have efficacy on children’s NAFLD in various areas such as glucolipid metabolism, intestinal bacterial metabolism, oxidative stress, and anti-inflammatory response. This article aims to provide an overview of the possible mechanisms of NAFLD in children and the potential therapeutic application of metformin.

Areas covered

The Cochrane Library, PubMed, Scopus, and EMBASE database was systematically searched on 12 April 2022, using the keywords metformin; non-alcoholic fatty liver disease; and children to identify similar studies. An additional search for recently published research was performed in June 2020.

Expert opinion

Although metformin has been proved to have an excellent therapeutic effect on children’s NAFLD; we can still explore its potential impacts and mechanisms from different angles, such as combined medication. At the same time, we should also pay attention to its side effects.

KEYWORDS:

• Metformin
• non-alcoholic fatty liver disease
• pharmacology
• children
• review

Article highlights

• Though an increasing number of children are suffering from NAFLD, there wasn’t until now any drug for this liver disease. Also, there isn’t any study concerning the link between metformin and the reversal of NAFLD in children, except in our research.

• In our study, the pathogenesis of NAFLD was widely collected from other studies focusing on NAFLD in children.

• Not only had our study mentioned clinical studies on the efficacy of metformin in children’s NAFLD, but our study also presented its mechanisms in vitro.

• From single therapeutic effects to multiple therapeutic efficacies, the mechanisms of metformin in children’s NAFLD were listed systematically in our study.

• In our study, metformin is advised to be taken with other drugs for a synergistic effect.

Acknowledgments

The author thank to Professor Yan Sun from the Department of Gastroenterology, the third affiliated Hospital of Guangzhou Medical University, who carefully reviewed the manuscript and provided their expert opinion.

Author contributions

QL Wu, SX Zeng, and JY Peng designed the study and drafted the manuscript. Y Yuan, Z Zhu, and ZC Xie collected data. ZH Huang, JS Huang, and JM Lai analyzed the data. JA Chen and MH Lin refined the manuscript and coordination. All authors read and approved the final manuscript.

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Data availability statement

The data that support the findings of this study are openly available in PubMed at https://pubmed.ncbi.nlm.nih.gov/.

Additional information

Funding

This paper was not funded.